BACKGROUND: In this qualitative analysis, we describe perceptions of patient-clinician interactions, from patients with complicated urinary tract infections (cUTI) and their treating clinician to inform future research on implementation of patient-reported outcome measures (PROMs) into clinical practice.
METHODS: Hospitalized patients with cUTI in an academic healthcare system in the Southeastern U.S. were interviewed 10-20 days after urine culture. Clinicians who cared for these patients for ≥2 days were eligible for interview, occurring 7-30 days after qualifying urine culture. Semi-structured, individual interviews were conducted between 10/2022–5/2023 by two interviewers via phone or Zoom. We employed both structural and content analysis within and across patient-clinician dyads (1 patient and 1 treating clinician) or triads (1 patient and 2 treating clinicians). Rapid, matrix, and team-based qualitative techniques were used to facilitate analysis and presentation. We primarily focused on a subset of questions to describe interactions among patients and clinicians; however, full interviews were informed by the parent study which examined the impact of cUTI on health-related quality of life.
FINDINGS: We interviewed 12 patients and 16 treating clinicians, comprising 8 patient-clinician dyads and 4 triads. Four concepts were identified: 1) time spent, 2) unknowns of care, 3) care coordination, and 4) discharge optimization. Findings indicate a clear need for implementation of PROMs in health services delivery to promote communication among patients and clinicians, facilitating open and constructive dialogue throughout the care continuum, including discharge and follow-up care. It is critical that symptoms and their impacts are methodically captured and appropriately prioritized within the patients’ individual context by all providers involved in care. For patients with cUTI, further exploration of how PROMs can be implemented within inpatient and acute settings is needed.
IMPLICATIONS FOR D&I RESEARCH: Facilitating tailored communication, care coordination, and the integration of both patient and clinician perspectives into healthcare delivery can promote patient-centered care that is responsive to and supportive of the needs of individuals treating as well as affected by cUTIs. Future D&I research using PROMs in patient-clinician interactions is needed to optimize the pace of and address the delayed adoption of PROMs in clinical practice.
